European Journal of Cardiovascular Medicine

A total number of 4,61,312 road accidents have been reported by Police Departments of States and Union Territories (UTs) in India during the calendar year 2022, claiming 1,68,491 lives and causing injuries to 4,43,366 persons [1].TBI is the main cause of one-third to one-half of all trauma deaths and the leading cause of disability in people under forty, severely disabling 15–20/100,000 populations per year [2].

The World Health Organization estimates that almost 90% of deaths due to injuries occur in low- and middle-income countries (LAMICs), where 85% of the population live, and this situation will continue to represent an important global health problem in the upcoming years. [3,4]

India and other developing countries are facing the major challenges of prevention, prehospital care, management of severe and moderate TBI, and rehabilitation in their rapidly changing environments to reduce the burden of TBIs [5].

The importance of continuous evaluation of TBI-related epidemiology and outcomes is emphasized by trends as described in this study.

AIMS AND OBJECTIVES

1. To determine the age group most traumatic brain injuries, occur.
2. To find out the gender in which most traumatic brain injuries occur.
3. To find out the various modes of traumatic brain injury [TBI].

Design:

In this retrospective study, we considered all patients with TBI admitted to the Department of Neurosurgery of Guntur Medical College from Jan 1st, 2023 – Dec 31, 2023.

Inclusion criteria:

The patients whose admission with TBI in the Department of Neurosurgery of Guntur Medical College were included in the study.

Exclusion criteria:

GCS -E4V5M6 and TBI which didn't require admission were excluded.

Clinical injury severity was based on the post-resuscitation GCS score at admission to ED.

A total of 924 patients were enrolled in the study. Out of which 797 were male and 127 were female .108 cases are in the paediatric age group up from newborn to 15 years of age. [Table 1]

Table 1. Cases registered by age group.

The most common mode of TBI is RTA [89.28%], followed by Self fall [5.51%] and Assaults [5.19%] [Table 2]

Table 2. Causes of cases by gender

India has the highest rate of TBIs in the world. More than 100,000 lives are lost every year with over 1 million suffering from serious TBIs in India [6]. Multicentric data may be helpful in a country like India. We undertook a retrospective study of TBI admitted to the neurosurgery Department, Guntur Medical College regarded as tertiary care to evaluate admission characteristics of 924 consecutive patients. According to this study, TBI predominated in young men in the form of severe TBI and mostly occurred due to RTAs.  These results can also be interpreted in the context of a very low degree of public health awareness about vehicular trauma, and decreased legislation regarding violations for speeding, jumping red lights, restraining devices, helmets, and drunken driving.

The male-to-female ratio was 6.22: 1 and this approximate ratio was also observed in other Indian studies.[7].

The age distribution of TBIs across various Indian studies including the present study found that moderate and severe injury mostly affected young men and mostly due to RTAs.[8]

The highest incidence of TBI was in the age group 31-40 which was in the line of reported mean age in some previous studies in India and other developing countries [9,10,11,12]. However, being the world's largest youthful country, our study indicated that road traffic injuries are the leading cause of TBIs followed by falls and assaults. Almost similar distribution was reported in various parts of the country and other parts of the world [9,10,11,12]. In this study, the second leading cause was falling, and more proportion was observed in children aged < 10 years [8]. Other Indian studies have also highlighted the increasing role of falls, especially in children.

Strength:

This study, based on the large sample size shall be a good document for the epidemiology of TBI. Using this study, there is a great potential to carry out policy-making and public awareness programs and sensitization of trauma care teams.

Limitation:

There is no Transgender group in this study. There is a good chance that only a certain proportion of all traumatic brain injuries that occurred in this region will reach this hospital as other trauma centres are also available, and many of those with severe injuries may have died in the prehospital setting, and many with mild injuries may not have sought treatment.

This is one of the latest studies from the Indian subcontinent that gave data on the admission characteristics, mode of TBI, age group, and gender group. Most of the injuries occurred due to RTAs, more common among the economically productive age group and mostly in males. Knowledge about the causes, patterns, and distribution of epidemiology among TBI patients from this study will be extremely helpful in policymaking, research, health management, prevention of TBI, and rehabilitation at the national level in our country and other developing nations.

This is a study conducted at a district headquarters medical college level with radial population habitation and highway proximity. It has both urban and rural populations in its catering area.

Regular and multicentric studies will provide comprehensive and distinctive data about the epidemiology of traumatic brain injuries in this vast subcontinent of India.

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